FIRST LIGHT RESIDENTIAL CARE, ST. LOUIS PARK

provider_name-FIRST LIGHT RESIDENTIAL CARE

physical_address- 2935 AQUILA AVENUE SOUTH

physical_city-ST. LOUIS PARK

physical_state -MN

physical_zip- 55426

county_name-HENNEPIN

telephone- 9523141216

adminstrator/authorized_agent- SHAMSO HASSAN

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 35226

license_number- 421142

medicare_number-

mn_classification- ASSISTED LIVING FACILITY

federal_classification-

hcbs_designation-

hosp-N

alf-4

https://www.health.state.mn.us/facilities/regulation/assistedliving/index.html

https://www.revisor.mn.gov/statutes/cite/144G.91